‘Black’ and ‘white’ in the greys of pandemic

‘Black’ and ‘white’ in the greys of pandemic: Recovering from Covid-19 may not be the end of sufferings for all infected people. The use of steroids in treatment and weak body immunity may result in a life-threatening disease which can rapidly spread in the body. This is ‘black fungus’ or mucormycosis, a rare but serious infection.

To buy our online courses:  Click Here

Mucormycosis originates in the nasal sinus and spreads rapidly around the facial area, including the brain. There have also been cases of vision loss from glaucoma—permanent loss of eyesight owing to damage of the optic nerve.

The numbers of cases in India in the second wave of the coronavirus pandemic are threatening to further overwhelm hospitals, especially because when the disease enters a hospital with piped oxygen supply, infection in one patient may quickly spread to those that are on the same gas line. The infection is often fatal when it spreads to the brain.

People catch this rare infection by coming in contact with the fungal spores in the environment. It can also develop on the skin after the fungus enters the skin through a cut, scrape, burn, or other type of skin trauma. This is a fungus that breeds on wet surfaces.

The symptoms of mucormycosis infection in the lung are often the same as that of Covid-19—fever, cough, shortness of breath, and could aggravate the condition of an ailing person.

Various reports indicate that doctors would earlier get just two to three cases of mucormycosis in a year, but now, doctors have been diagnosing two to three cases every month. Although there is no outbreak of this disease, doctors insist that the occurrence of the infections has gone up exponentially in recent months.

In the national capital, AIIMS is reporting more than 20 cases of this disease on a daily basis. This infection is not new, but that it is seen rising in correlation with admitted covid patients, makes the situation alarming.

The possibility of contracting black fungus is very high because of low immunity. If diabetic people test positive for covid, then their sugar needs to be strictly controlled in addition to rational use of steroids.

Cases of mucormycosis started surfacing two months ago and states like Gujarat and Maharashtra have, so far, reported more than 1,800 cases. Most of those are the ones who have taken high doses of steroids or are diabetic.

In the light of rising cases across India, the Central government asked states to make mucormycosis a notifiable disease under Epidemic Diseases Act, 1897, as per which, all government and private healthcare facilities shall follow guidelines for screening, diagnosis, and management of black fungus issued by the Union Ministry of Health and Indian Council of Medical Research.

A notifiable disease means the government has to be mandatorily informed about any case that is detected. Among the other notifiable diseases in the country are tuberculosis, cholera and diphtheria.

Doctors are observing increasing instances of mucormycosis and aspergillosis (an infection in the lungs, less lethal than mucormycosis)—both fungal—and loss of vision from glaucoma, in Covid patients on prolonged or high-dose intake of steroids.

While steroids such as dexamethasone and methylprednisolone are known to play a critical role in reducing deaths from Covid, its prolonged use, or use in high dosage, may lead to complications.

Medical experts share the concern that while steroids are essential medicines known to reduce deaths from Covid, there is a need to bring to highlight the trend of increasing cases of mucormycosis, glaucoma, and cataract in patients who were administered steroids during their Covid treatment, the majority of whom had a history of diabetes.

Experts suggest that those who have recovered from Covid-19 should be on the lookout for symptoms of mucormycosis such as stuffy nose, headache, black lesions on the upper inside of the mouth, facial pain, and loss of vision. The illnesses resulting from aspergillosis infection that usually affect the respiratory system, common symptoms include breathlessness, cough, and fatigue. A feeling of pressure on the eyeballs and constant headache are primary symptoms of glaucoma.

After a viral multimedia report by news agency Reuters depicted that some people in Gujarat have resorted to “going to cow shelters once a week to cover their bodies in cow dung and urine in the hope it will boost their immunity against, or help them recover from, the coronavirus”, doctors have raised the alarm over this trend as this could possibly add to cases of mucormycosis, which has been reported among some recovered patients who were administered steroids during Covid treatment.

Mucormycetes, the group of fungi that cause mucormycosis, are present throughout the environment, particularly in soil and in association with decaying organic matter, such as leaves, compost piles, and animal dung. Hence, there is a direct relationship between using dung and attracting this fungus.

To compound the woes of the ailing and the suffering in this pandemic, white fungus—which is more dangerous than black fungus—is reported to have made appearance in India. White fungus infection is more dangerous than black fungus infection because it affects lungs as well as other parts of the body including nails, skin, stomach, kidney, brain, private parts, and mouth.

(‘Black’ and ‘white’ in the greys of pandemic)

Also Read: Arab Israel Conflict

Four cases of white fungus infection have been reported from Patna in Bihar so far. One of the infected patients is a famous doctor from that city. According to Chief of Microbiology at Patna Medical College and Hospital, Dr S N Singh, all the four persons infected with white fungus showed coronavirus-type symptoms but they were not COVID-19 positive; although their lungs were found infected and after tests when they were given anti-fungal medicines, then they recovered.

Similar to black fungus, white fungus is also more dangerous for those who have weak immunity. Diabetes patients and those who are taking steroids for a long period of time are at higher risk of getting infected.

White fungus can also affect those covid patients who are on oxygen support and can directly affecting the lungs of these patients. Doctors inform that white fungus it is the main reason of Leucorrhoea—a whitish, yellowish, or greenish vaginal discharge that may be a sign of infection.

This fungal infection can best be prevented by sanitising the oxygen or ventilator properly.

(‘Black’ and ‘white’ in the greys of pandemic)